I thought BF babies couldn't be constipated?

My son is now 6 weeks and for the past 3 weeks he has been extremely fussy and crying non stop, but it's worse at night. I went to the pediatrician twice for this. First time, he told me to get simethicone drops. It made no difference. Second time, i started thinking my son may have reflux. Pediatrician told me to try ranitidine 2x a day. It made no difference. I also tried gripe water... it didn't do anything. He doesn't get the 12-18 hours of sleep a day that he's supposed to get at all. If he gets 3 hours total i'm lucky. He will be sleeping peacefully and wake up screaming in pain. He does have wet burps/hiccups. He uses me as a pacifier, which besides the fact that i'm very sore, I do not really mind but he wakes up every 1/2 hour to every hours at night, that is if i am lucky to get any sleep at all. Some nights, I will have to rock him in the recliner for 8+ hours non stop. I am not sure that I want to believe in what is called "colic". What is it anyway? It seems like no one knows. He does seem to be struggling with passing gas... even if I burp him during feedings, after feedings, we take warm baths together, i give him tummy massages, bicycle legs, you name it. He used to poop 3-4 times a day and now it is max. once a day if at all. It's like he's constipated but i thought BF babies couldn't be? His poop is still yellow mustardy color but it has a different smell than it used to have. Before it didn't smell too bad, like BF poop smells, but now it's awful. It's like rotten old socks. Sorry for TMI Haha!! Anyways I am exhausted, I cry nearly every day, my husband feels helpless and we are at a loss here. The pediatrician seems to think that a baby in pain is totally normal and doesn't seem to want to help us. He told us that he would outgrow this by the time he's 3-4 months! We're driving nuts here and we're worried, anyone has any idea of what could be going on?

Re: I thought BF babies couldn't be constipated?

He's not constipated. If he is still pooping, even if he is pooping less, then he's not constipated. His poops will get more and more stinky, but as long as they are consistent in color and texture he should be fine. If his poop looks green, black, has any blood in it, or is coming out in hard pellets -these are signs of a problem and you should call the pediatrician.

Re: I thought BF babies couldn't be constipated?

I don't have much time to read with the constant crying, but I have watched the happiest baby on the block on DVD and tried it when baby was in a rather good mood and I had the best night sleep since he was born. But when he's in pain, Dr. Karp theory doesn't work with my baby

Re: I thought BF babies couldn't be constipated?

Good question. Instinct maybe? The crying is just different. I know he's struggling with something. When he's got a dry diaper and he's fed, he should be relaxed but he isn't. I also don't believe that infants this young can cry for no reason.

Re: I thought BF babies couldn't be constipated?

Some babies are more gassy than others. Mine was like that, and I wouldn't say he was colicky, but he had his days where nothing seemed to calm him, and I think gas was often the culprit. I tried all the remedies but in the end only time was the cure.

In the meantime, keep up with the tummy massage. I found the most helpful move for letting out gas was pushing his knee up towards the opposite shoulder, one at a time.
The most comfortable hold for our gassy boy was the loaf-of-bread or football hold, where you hold his crotch in your hand and his belly lays along your forearm, his head at your elbow. This is a convenient one armed hold, so you can get something else done with your other arm while holding a calm/sleeping baby.
Some people also swear chiropractic care helps with baby gas. We did it for a few months, I am not so sure how much it helped, but I am throwing it out there for you.

Re: I thought BF babies couldn't be constipated?

Hmm... I wonder if maybe he's under stimulated? Or over stimulated? Or too warm or too cold? Or maybe it's something weird like he doesn't like the texture of his clothes or a blanket? Does a warm bath calm him? I'm not sure what else I'd do in this situation. I hope you can find a solution!

Re: I thought BF babies couldn't be constipated?

Colic is defined as episodes of crying that last for 3 or more hours per day, for 3 or more days per week, in an infant who is 3 or more weeks old, in an otherwise healthy child. If that sounds nebulous to you, it's because it is a poorly understood condition. We don't really know what it is- more what it isn't. It's not gas or constipation- imagery done on colicky babies reveals no more gas than in non-colicky ones. It's not mom's diet- the moms of colicky babies aren't eating anything different from the moms of non-colicky ones.

We do know that there is a developmental aspect to colic; colic typically peaks between 3 weeks and 3-4 months, and babies who are born prematurely experience colic in the same age range, adjusted for their prematurity (i.e. a baby born 3 weeks early will experience colic onset at around 6 weeks rather than at 3 weeks). This suggests that colic in a neurodevelopmental phenomenon rather than a physical one. There's an interesting correlation with migraine- a recent study published in the Journal of the American Medical Association found that colicky babies are something like 7x more likely to suffer from migraines later in life than non-colicky babies.

We also know that colic is EXTREMELY distressing to parents. Parents of colicky babies are more likely to suffer from anxiety and depression, to have relationship stress, and to become exhausted. Breastfeeding is more likely to fail- usually due to parents being willing to try ANYTHING to stop the crying, and formula qualifies as "anything". Colicky babies are more likely than non-colicky ones to experience abuse at the hands of their caregivers.

Basically, what I am saying is that it doesn't matter if you want to believe in colic. It's real and it's nasty.

If your baby is colicky, or even if he's not but is merely fussy, here are some things you can do:
- Nurse as much as possible. Baby can't cry if there's a breast in his mouth.
- Calm house. Lights, TV, and stereo turned down or off.
- White noise. Dryer sounds, radio static, noise from a fan, etc.
- Motion. Rock, stroll, swing, bounce, etc.
- Warm water. Give baby a soap-free bath in the sink or take him in the tub or shower with you. Extra points if you nurse in the water. Warm water is also really good for anything related to baby having gas or needing to poop- it's relaxing and often helps the baby get things moving.
- Trip outside.

Basically, the tips above are all about changing the baby's incoming sensory stimuli. Nothing is likely to work for long, so you have to keep changing it up!

That all being said, 1 thing does jump out at me from your post and that is the poop smell. Breastfed baby poop is tropically pretty inoffensive. So when it really stinks, I start thinking about 2 things: allergies/intolerances, and lactose overload. If you don't feel that you have signs of high supply (e.g. frequent feelings of fullness or engorgement, strong letdowns, tons of leaking, baby coughing, gagging, spluttering, or making a click noise while nursing), then I personally would try reducing the amount of cow's milk in your diet (including foods where dairy is an ingredient) and see if that makes a difference. If you do have signs of high supply, let us know and we'll talk you through some strategies to manage it.

ETA: What you describe isn't constipation. Constipation is stool that is dry, hard, and pellet-like, and produced infrequently. Breastfed babies who are >6 weeks old will often poop as little as 1x per week or even less frequently, but this is not constipation because the poop is soft when it emerges.

Re: I thought BF babies couldn't be constipated?

Thank you for all this information. I take him in the tub with me once a day, I try to do this before bedtime to create a routine for him. He loves the warm water and the tub is the one place where I have yet to see him cry. Everytime we're in there I nurse him and we stay in there for quite some time. It's true that it helps things moving, it worked a few times at least (once on me )

Baby can't cry if there's a breast in his mouth... very true. But after a while of this sucking, I am sore. Is this normal? It feels like the nipple is raw and I need to give it a break.

I am lactose intolerant myself so I don't eat any dairy in the first place. I've also eliminated a LOT of stuff from my diet in the past week (nuts, tomatoes, brocolli, cabbage, etc) and haven't seen any difference.

I cannot say that I have frequent feelings of fullness/engorgement, I have a few times before but that was when he was so upset that he didn't want to nurse. If I go over 3 hours without nursing I feel like i'm going to explode. I leak mostly when there is extreme fullness. Almost everytime I nurse him he will gag and I will have to pat his back for him to cough and continue to nurse. It didn't occur to me that I might be the problem until now. Could it be that I have a strong let down and baby is having trouble with it? Could it cause him to be super gassy?

Re: I thought BF babies couldn't be constipated?

If he's happy in the tub, I suggest you invest in a larger hot water heater! Who cares if he poops on you? Drain the tub, rinse yourselves off, and fill it up again.

You shouldn't be sore after nursing. When a baby is properly latched, he can suck literally nonstop without making mom sore. Can you describe the soreness some more? For example:
- Is it more of a pinching pain, or more of an itching or burning?
- Does it happen primarily at the end of the feeding, in between feedings, or at the beginning of the feeding?
- Do you ever observe the nipple blanching (turning white) or turning bluish-purple before returning to a normal color?
- Does cold make the pain worse?

When it comes to dietary elimination, the big offenders tend to be dairy, wheat, and soy. The foods you mentioned- tomatoes, nuts, cruciferous vegetables like broccoli- tend not to cause problems.

If you feel like you are going to "explode" after 3 hours of not nursing and your baby is gagging and coughing while nursing, there is an excellent chance that you have a high supply. Having a lot of milk can cause problems for three main reasons:
1. Fast letdowns cause the baby to have difficulty nursing, and he may be gulping down a lot of air as he feeds.
2. Babies often control fast letdowns by compressing mom's nipple, and that can cause pain for mom.
3. When mom has a lot of milk, the baby is likely to get a lot of lactose, and this can cause gastrointestinal irritation. This does not mean that the baby is lactose intolerant, even though you are!!!! Except in very rare and life-threatening cases, babies are designed to digest lactose; production of lactase (the enzyme that digests lactose) peaks in early infancy. But the excess lactose from the high supply can overwhelm the baby's lactase production.

If high supply is the problem, here are some things to try:
1. Reclined feedings. Reclining enlists gravity to slow milk flow to the baby, reducing the amount he struggles with fast flow and his need to control the flow by clamping down on the nipple.
2. Give baby a probiotic supplement. Recent research suggests that probiotics can help the baby's digestion and can help decrease colic symptoms.